Determinants of iodine deficiency in school children in different regions of Ethiopia.

OBJECTIVE: To determine the magnitude of goitre in school children and measure indicators of iodine deficiency including the most commonly consumed staple foods. DESIGN: A cross-sectional study. SETTING: Ten villages from four administrative regions of Ethiopia. SUBJECTS: A total of 2485 randomly selected elementary school children were examined for clinical signs of goitre. Indicators of iodine deficiency disorders (IDD) assessed were urinary iodine excretion (UIE) rate, iodine concentration in water, the commonly consumed individual foods of plant origin and milk, and bacterial contamination of drinking water. RESULTS: The gross prevalence (mean of male and female values) among school children was 53.3%. The prevalence was higher in females (56.1%) than in males (50.8%). The highest prevalence (82 and 91%, respectively) were observed in the villages of Lotte and Kodowono and the lowest (31%) in the village of Abossara. Of the urinary measurements, 70% of the samples showed moderate and 30% mild iodine deficiency. Levels of iodine in water and individual food samples were low in general. Breast milk iodine content was similarly low and related to the maternal daily iodine intake which may affect the nutritional status of the nursing infant. The study also provides further evidence that coliforms and E. coli isolated from drinking water contribute to the high incidence of endemic goitre other than iodine deficiency. CONCLUSION: It is difficult to obtain a sufficient iodine intake in the survey villages as the individual foods are very low in the element. However, IDD can be prevented by ensuring normal iodine nutrition through instituting ways that avail iodinated salt to the survey population.

Health effects of cassava consumption in south Ethiopia.

Health problems associated with cassava consumption was studied in three villages (Kodowono, Lotte and Woidewashe) of Gamo-Gofa, South Ethiopia. Total goitre rate (% TGR) increased with increasing rate of cassava consumption while, urinary iodine excretion (UIE) was found to be in the normal value range for the three villages. In both males and females incidence of goitre after the introduction of cassava to Kodowono village was significantly higher than before introduction of cassava (p < 0.001). This may indicate that the high rate of goitre is attributed to the frequency of cassava consumption. Of 450 individuals interviewed for health problems associated with cassava meal consumption, 50% reported that they were suffering from epigastric burning pain and dizziness while 38.7% reported abdominal distention and vomiting. Vomiting was relatively higher in the age group 20 years and below than it was in those above 20 years of age. These problems may be attributed to cassava consumption because, cassava contains cyanide which results in intoxication when poorly processed cassava meal is taken. Goitre prevalence and health problems attributed to cassava consumption therefore, necessitate an intervention programme to control iodine deficiency disorders (IDD), develop appropriate processing techniques to eliminate cassava toxicity and educate villagers on how to prepare safer meals from cassava.